Dealing With Perinatal Loss: What You Can Do & Who Can Help

Types of Perinatal Loss

There are several different types of perinatal loss that a family can experience, including chemical pregnancy, miscarriage, and stillbirth. Infertility can also be experienced by families as a loss. The risk of a perinatal loss is highest during the first 12 weeks of a pregnancy and then decreases after that point. However, pregnancy losses can occur at any point during a pregnancy.

Here are four types of perinatal loss:

1. Inability to Conceive

Infertility, or difficulty conceiving a child, is not typically regarded as a type of pregnancy loss, but it can feel like a loss to families. Infertility is defined as difficulty getting pregnant within one year of trying for women under 35, or six months of trying for women 35 and older.²

In some cases it may be related to a medical issue found in the mother or father, but  other times there is no known cause. Around 10% of women in the United States are coping with infertility.

2. Chemical Pregnancy

A chemical pregnancy is an early pregnancy loss that occurs during the first six weeks of pregnancy.³ Oftentimes, women who experience a chemical pregnancy will have a positive pregnancy test, but are unable to detect a fetus on an ultrasound. Because this type of loss occurs so early on, some women are not even aware that they suffered a chemical pregnancy.

Even though this loss occurs early, it can be devastating to learn that you are pregnant only to find out that you suffered a loss. Around 50 to 75% of pregnancy losses are chemical pregnancies.

3. Miscarriage

Miscarriage refers to a pregnancy loss that occurs within the first 20 weeks of a pregnancy.^1,4 The majority of miscarriages are caused by genetic abnormalities in the fetus. The risk of miscarriage increases with age. For women ages 20 to 30, there is an 8.9% chance of miscarriage during the first 20 weeks of pregnancy, but for women over age 40 it rises to almost 75%.

4. Stillbirth

Stillbirth is a pregnancy loss that occurs after 20 weeks of pregnancy or during delivery.¹ This type of loss may be related to genetic abnormalities, slow fetal growth, infection, or issues with the placenta, but sometimes there is no known cause. Stillbirth is the least common type of pregnancy loss, but affects one in 160 births in the United States.⁵

The Emotional Impact of Dealing With Perinatal Loss

Grief is an individual experience that can vary significantly from person to person.⁶ For many families, physical and psychological symptoms are common following a perinatal loss, including sleep issues, change in appetite, and the stages of grief.

Physical Symptoms

Grief reactions after a perinatal loss can cause physical symptoms similar to symptoms of depression. For some families, the physical symptoms of grief can be severe enough to interfere with their ability to function at work or school, keep up with responsibilities at home, and care for other children.

Physical symptoms of grief following a perinatal loss include:⁷

• Sleeping problems, either sleeping too much or too little
• Appetite loss
• Stomach problems
• Fatigue
• Feeling weak or run down

Psychological Symptoms

You may experience a range of psychological symptoms when dealing with a perinatal loss, including shock, anger, guilt, and sadness.¹ These emotions can be overwhelming, but they are all normal reactions to the loss of something special to you.

There is no order or timeline for how long the grief process may take. The five stages are one model, but it’s a myth that everyone experiences grief the same way. Each person’s experience of coping with grief is different, and people sometimes go through the same stage more than once.

Psychological symptoms may include:^6,8

• Overwhelm, shock, or numbness
• Isolation
• Anger
• Guilt and shame
• Depression
• Anxiety
• Post-traumatic stress disorder (PTSD)
• Suicidal thoughts
• Complicated grief

How Perinatal Loss Affects Couples & Families

Perinatal loss affects the entire family; however, the ways in which mothers and fathers grieve may be different. Research on fathers who have suffered a perinatal loss have found that they tend to show less intense grief symptoms and grieve for shorter periods of time.⁸ They are also less likely to talk about the loss with other people, including their partners.

The relationship between a couple may be negatively impacted after a loss. Partners who grieve differently from one another are more likely to experience problems in their relationship.⁸ For example, if a mother wants to openly talk about the loss but the father is uncomfortable doing so, this can cause tension in the marriage.

Couples who feel less satisfied in their marriage are also more likely to have a hard time coping with their grief.⁹ Couples can benefit from open communication and understanding following a loss. By working together, the couple may be able to work through their grief and strengthen their relationship.

How to Cope With Perinatal Loss

Grieving pregnancy loss can permanently change you. You may continue to deal with grief, especially around holidays and anniversaries of the loss (i.e., the anniversary effect). While you will never “get over” the loss, you can help yourself move forward by taking active steps to cope and find acceptance.

Here are five ways to cope with perinatal loss:

1. Reach Out For Support

Remaining connected with people during this time can help you cope. If you have positive and supportive people in your life, call them or get together. It may be difficult to motivate yourself to do this, but there’s a good chance that you will feel better afterwards. If you’re religious or spiritual, you may also consider reaching out to a spiritual advisor for support during this time.

2. Attend a Support Group

Support groups and group therapy are available for families dealing with a perinatal loss. They allow you to meet with other families who have experienced a loss and share your experiences with one another. These groups are typically run by mental health professionals and are available online and in-person.

3. Speak With a Grief Counselor

If you are having a hard time grieving pregnancy loss or feel that your support system is not enough, you can benefit from speaking with a mental health professional who specializes in grief counseling. Professionals will not only help support you through your loss, but also guide you toward the acceptance stage of grief.

If you are struggling in your marriage or relationship following a loss, you can also consider couples therapy to help work through your issues together.

4. Honor Your Unborn Child

Some families find solace in commemorating their unborn child. You can do this in whatever way feels special to you. For example, create a memory box, piece of artwork, or jewelry for your baby. If you experienced a stillbirth, you may have the opportunity to have a funeral with loved ones. You can also plan something special each year on the anniversary of your loss to honor your child.

5. Practice Physical Self-care

Prioritize your physical well-being because it impacts your emotional health as well. Focus on eating healthy foods, drinking water, getting rest, and avoiding alcohol. It’s extremely important to continue discussing any health-related issues with the appropriate healthcare provider. If possible, engage in some form of exercise every week. This could be something as simple as going for a walk.

Who Should I Consult For Help After Pregnancy Loss?

Because of medical issues that can arise, it’s important to stay connected with your primary care physician and OB-GYN. They’ll be able to monitor your health after the loss and determine if any medical issues were the cause. In some cases, they may refer you to a specialist for further evaluation.

You can benefit from speaking with a mental health professional, too. For more support, seek out a psychologist, marriage and family therapist, counselor, or social worker that specializes in this area. They will be able to provide you with ongoing support and help you cope with your loss.

If you’re experiencing anxiety, depression, or other emotional symptoms that are interfering with your life, you might also think about meeting with a psychiatrist or psychiatric nurse practitioner. They will evaluate and determine whether you would benefit from mental health medication.

How to Find a Therapist

If you’re ready to find and choose a therapist, consult a free online directory. If you have friends or family who have experienced perinatal loss or the loss of a child, ask whether they attended therapy. If they did and felt connected with their therapist, ask for a recommendation.

How Long Does it Take to Recover From Perinatal Loss?

There’s no way to predict how long it takes to recover from perinatal loss.⁶ While recovery from depression or anxiety means an absence of symptoms, grief symptoms may never go away completely. The person will still think about the loss, but with acceptance. They may continue to feel sad and anxious, especially around anniversaries, but symptoms should no longer significantly interfere with their ability to function.

While there’s no specific grief timeline, studies on perinatal loss have found that depression may peak around six months after the loss and gradually decrease over the first year.⁸ In cases of complicated grief, these symptoms may increase again in the second year.

Supporting a Friend or Family Member Through Perinatal Loss

Seeing a family member or friend struggle with a perinatal loss can be difficult. Avoid the urge to “fix” what your loved one is going through. You might find yourself wanting to reassure them that it will “get better” or that the loss was “for the best.” Instead, try just listening, expressing empathy (e.g. “this must be so hard), and offering help.

Here are ways to support a friend or family member going through perinatal loss:

• Offer to drop off meals or help with household tasks
• Be patient; grief has no timeline
• Reach out around the anniversary of the loss

If your loved one is continuing to struggle with grief, you may consider suggesting that they seek professional help or attend a support group. You can even offer to attend a support group with them for the first time (be sure to check with the group first to make sure this is OK) or help them find a therapist.

Try to offer the suggestion in a non-judgmental manner and avoid pressuring them. If they are uncomfortable with the idea, respect their decision and continue to be there to listen and offer support.

Statistics On Perinatal Loss

Though perinatal loss is rarely spoken about, it is more common than many people realize. A significant number of families are impacted by a perinatal loss at some point. Knowing the statistics on perinatal loss can help families experiencing a loss to feel less alone.

Consider the following statistics on perinatal loss:

• 10 to 15% of pregnancies that are confirmed end up in miscarriage or stillbirth¹
• Approximately 80% of miscarriages occur during the first trimester of pregnancy⁴
• Each year in the United States approximately 24,000 babies, or one out of every 160 births, are stillborn⁵
• Around 1 to 2% of women experience repeat miscarriages, which is defined as three consecutive miscarriages in the first 20 weeks of pregnancy¹⁰
• After a woman experiences two pregnancy losses, her chance of a future miscarriage is 30%. After experiencing three losses, her chance of a miscarriage rises to 33%.¹

Final Thoughts on Coping With Perinatal Loss

A perinatal loss, or the loss of an infant or child, is one of the most painful things that can happen to a person. While the goal of coping with your grief isn’t to “get over” the pain, it should still ease in time. There is no “right” amount of time to grieve; indeed, you may be grieving for the rest of your life, but finding acceptance can allow you to function and find joy again.